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Bedwetting – Symptoms & Risk Factors


Symptoms


If your child is older than five years of age and has primary bedwetting they may:
  • Urinate by accident during sleep at least twice a week
  • Regularly stay dry during sleep for a period of at least six months in the past
If you or your child is older than five years of age and have secondary bedwetting they may:
  • Urinate by accident during sleep at least twice a week
  • Regularly stay dry during sleep for a period of at least six straight months in the past
It is also important to know if there is something else that is causing the bedwetting. It may be a result of one of the following:
  • Another sleep disorder
  • A medical condition
  • Medication use
  • A mental health disorder
  • Substance abuse

Risk Factors


Primary bedwetting is present at the following rates in children and teens:
  • 10% of six-year-olds
  • 7% of seven-year-olds
  • 5% of 10-year-olds
  • 3% of 12-year-olds
  • 1% to 2% of 18-year-olds
Primary bedwetting is more common in boys than in girls. The rate of children with primary bedwetting who get better on their own is about 15% each year. 

There appears to be a genetic link to primary bedwetting. Children are more likely to have it if their parents and/or siblings had it as children. Bedwetting is reported by 2.1% of older adults in assisted-living homes. It is more common among women than men.

Some people may also urinate by accident when they are awake. This tends to be related to a physical problem. Social or mental stress is rarely the cause of primary bedwetting. But it does occur more often in the following children:
  • Children with attention-deficit/hyperactivity disorder
  • Children living in disorganized families
Secondary bedwetting occurs more often in children who have recently faced a strong social or mental stress. This includes the following:
  • Parental divorce
  • Physical or sexual abuse
  • Neglect
Children with secondary bedwetting are also more likely to have constipation and to soil their pants. 

A disorder such as confusional arousals (waking during a very deep stage of sleep) may involve a child urinating in a strange place during sleep. Otherwise, this child tends to keep a dry bed at night.

Secondary bedwetting can occur at any age. It can be related to or caused by any of the following:
  • An inability to concentrate urine, as in sickle cell disease or some forms of diabetes
  • An increase in urine production caused by the use of caffeine, diuretics, or other substances
  • A urinary tract problem, such as urinary tract infections or an irritable bladder
  • Chronic constipation and involuntary soiling of the pants
  • A neurologic problem, such as seizures and epilepsy
  • Obstructive sleep apnea (OSA)
  • Social or psychological stress
  • Among older adults, it may be related to symptoms of the following:
  • Congestive heart failure
  • Obstructive sleep apnea (OSA)
  • Depression
  • Dementia
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